By David Shaywitz
Consumer health and well -being experience a flurry of activity.
The laboratory test company Function (Motto: “It’s time to own your health”) bought EzraAn MRI company throughout the body promises the world’s most advanced lifespan scan ‘.
Appearancemaker of the popular smart ring, Recently added An integration for continuous glucose measurement and the ability to calculate meal food based on a photo. Eara too hired Dr. Ricky Bloomfield as the first Chief Medical Officer; Dr. Bloomfield had previously served as a clinical and health information leader at Apple and is known for his expertise in the interoperability of the health data.
Meanwhile, our competitor BumpMaker of a smart band, just announced The latest versions of his device, with the possibility of checking blood pressure, ECG, ECG and to assess what it describes as a measure of biological age, which calls the ‘Whoop age’. Whoop now says that it is trying to “unlock human performance and health span”, which seduce users with the field: “Get a complete picture of your health.”
To a personal health system (OS)
Already notice a pattern?
What unites these approaches and So many othersSuch as the industry newsletter Fitt Insider (FI) recently observedthey reflect an attempt to generate a ‘personal health room control system’, intended to ‘give individual freedom of choice about their well-being’, and more in general, control back from a health system that is often observed (especially by young adults) as somewhere between useless and obstructive.
With reference to a recent nobleman questionnaireFI reports,
… almost half of the young adults believe that well -informed people can be just as well informed as doctors, two -thirds see lived experience as expertise and 61% regards institutions as obstacles to care.
Be good REACTIVE CAREMany already collect data about wearables, lifestyle apps, DTC diagnostics and more, but most are quiet. Rolling, function is the architecting of a uniform platform that is able to generate clinically relevant insights from raw input.
Fi points to the proliferation of companies like bright os, gyroscope, and guava health focused on “day-to-day data management,” as well as startups like superpower (“Delivering concier-level metrics” docto) and mito and mito and mito and mito and mito and mito and mito and mito and mito and mito and mito docto and mito) and mito docto and mito) and mito “Generates Comprehensive Digital Health Profiles by Merging Labs, Medical Records, Family History, Lifestyle Info, and More.”)
AI seems ready to play an always central role in many of these companies.
Fi speculates,
A step further, end-to-end LLMS can close the loop, link cause and effect, convert insights into actions, synchronization with PCPs and lay the foundation for one AI-driven medical future.
This is a good time to take a deep breath-if a closer, more critical view of this vision of consumer accompanied by data fortified health.
A powerful vision
Undoubtedly there is much to embrace here, including in particular:
- The possibility for individuals to collect more and richer health data from a greater variety of sources, including in certain wearables;
- The increased possibility of relevant Insights (A keyfall From early “quantified self” efforts) from this data.
- The explicit centralization of your health data around you (the slogan of SuperPower is “health data, in one place”), a long promised but often frustratingly elusive objective in practice in practice. Nowadays, still, (still!), So many patients notice that they have to beg and argue for efficient access to their own health information, data that health systems usually view as a competitive advantage And don’t want to let go.
A technically compatible approach to health where you have more abundant information about you, which are explicitly in your control, and that can lead to healthier behavior, represents the kind of progress it deserves to be celebrated.
At the same time, when I look at many of these health hearings, I see two broad concerns.
Concerning one: plural of fragile data may not be insight
The first, perhaps more concrete concerns, is that to paraphrase comedian Dennis Miller, “two of [crap] is [crap]”And just collecting a lot of data, a large part of which can be fragile, not sure will translate into brilliant insight, even if the magical power of AI is fervently invoked.
In a particularly penetrating blog post “Ground Waren” focused on “the business of promotion longevity and healthspan”, Dr. ir. Eric Topol writes That “getting hundreds of biomarker results and imaging tests in an individual greatly increases the chance of false-positive results”, a relevant option.
I discussed the challenge of false positives hereand go into a few details about the Bayes statement (who informs the assessment) here. The OG reference in this space can be this 2006 Paper van Zak Kohane and colleagues, in which they introduce the term ‘Incidentalome’.
To be honest, at least some of the proponents of extensive tests acknowledge the challenge of false positives, but they think that the possibility of collecting closed data about individuals over time, possibly important bends are observed, a point that Dr. Peter Attia explicitly emphasized in To survive; I am discussing his “risk management” mentality here.
Similarly, Nathan Price, a professor at the Buck Institute and the CSO of Thorne, has argued that close inspection (assisted by AI) of rich individual data (for example) can identify opportunities for supplementing intervention. These interventions may not make much difference at the population level (hence the scarcity of convincing data from clinical test for supplements, as Dr. Topol notes in his latest book, Super agents – Mine Wsj judgement here), but could be in selected individuals. (I also discuss the price here” here).
Proponents of the ‘Personal Health Health’ can also emphasize the presence of tail winds-the chance of improved predictions as measurement technologies become better, denser data is available and the AI tools are always possible. Perhaps we are not entirely on the point of realizing the future that we imagine, lawyers can claim, but we are close enough to start to see what it could look like.
Concern Two: A narrowed view of health
What is demonstrably a deeper concern about the health model we are going is the extent to which it seems to be informed by a rigid reductive mindset. In this limited, classical management (or consultant) display, health is simple statistics on a dashboard, an ever -increasing series of parameters that must be measured, optimized, optimized.
A recent, beautiful essay About our evolving understanding of and approach to happiness in the New York Times Magazine By Kwame Anthony Appiah reminds us of what we might miss.
We arrived around the start of the new millennium, writes Appiah
Life-hacking, self-confidence, habit-stacking era of optimization gurus such as Tim Ferriss, whose first book, published in 2007, was “the 4-hour working week”-“a toolkit” in his words, “for maximizing output per hour”.
Consequently, Appiah continues, the concept of flowering was dissected in “modular upgrades” while we refine our ‘personal operating system’.
Yet it is essential to acknowledge, Appiah writes, that “happiness is not an optimization problem”, but a little deeper and more substantial.
I reached for a similar point in 2018, in one part Titled: “We are not a dashboard.”
Note that the “Dashboard has become a powerful symbol of our age,” I wrote that “the ideology of big data has been given its own life, based on a feeling of both inevitability and self -justification.”
I continued: “From the measurement of people, we seem to be increasingly measuring in the service of data, setting up systems and organizations where constant measurement often seems to be a goal in itself.”
I am reminded of a favorite sentence of Kate Crawford’s Atlas van Ai (Mine Wsj judgement here): “The reimbursements of the tools become the horizon of truth”, a reminder, in this context, that even if we are flooded in tools that make the measurement and analysis of health data possible, we must ensure that our understanding of health transcends the limits of these tools.
Of course it is not to go the other way and to completely reject statistics.
As professor Jerry Muller, author of the brilliant book Tyranny of statistics, explains“I cannot see how competent experts can ignore statistics. The question is to evaluate the meaning of the statistics, and To recognize the role of the unmetified. (((emphasis).
I also spoke to this need in a 2011 part Entitled ‘What Silicon Valley does not understand about medicine’, writing ‘, a new technology platform that overlooks the integrated needs of patients or underestimates or does not take into account the complexity and mess of illness such as actually occurs and is experienced by patients (and closest to them)) inevitably fall short. “
Ahead
To most effectively meet the needs of patients – including the vital important goal of preventing or preventing diseases, so that people do not become patients – it is essential to embrace the power and promise of emerging technologies, including those that make the conceptualization of ‘personal health room’ possible, without confusing this card with the territory (as Alfredorium. famous instructed).
It will be essential to determine priorities – in collaboration with each patient – and to identify a handful of important health parameters on which they can concentrate; Drs. David Blumenthal and J. Michael McGinnis carefully discuss the subject of “core statistics” this 2015 Jama “Viewpoint.”
At the same time, we have to stick to a vision on health and well -being that extends far beyond the imprisonment of a dashboard and strives for something that goes beyond the recursive optimization of statistics (as I recently discussed here). Our approach must be more than enough to absorb other components of a healthy, flourishing life, to appreciate authentically and to cultivate meaningfully, including intellectual imprisonment, pursuing goal and social involvement with family, friends and community.
(Martin Seligman’s Perma – Model – Positive emotion/joy, involvement/current, relationships/connection with others, meaning/goal and performance – represents a potentially useful framework [see here, here] for expanding our thinking.)
Despite the difficulty, if non -outstanding impossibility, from reducing some of the most important and in -depth components from health to an easily digested number, we must continue to appreciate and prosecute it.
Even if we use emerging technology to construct and refine health dashboards, we let it decide to work on a more extensive, sustainable and meaningful vision of health that exists beyond the sterile syntax of rows, columns and figures.
Dr. Shaywitz, a doctor-scientist, is an old operator and investor in Health Tech, the founder of Amazing HealthTech, a teacher At Harvard Medical School and a deputy fellow at the American Enterprise Institute. This piece was originally published on the Carpenter -report
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